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Progressivism, Individualism, and the Public Intellectual

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Progressivism, Individualism, and the Public Intellectual DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY +++ Health Care Policy Alternatives An Analysis of CostsP fromROGRESSIVISM the Perspective of Outcomes , Abstract INDIVIDUALISM, AND The current focus on Health Care cost control has been from the perspectives of the inputs to the system; namely physician charges, hospital chargesT andHE drug costs. P ThisUBLIC paper attempts to present an outcome driven analysis of HealthCare costs to show that focusing in the outcomes and then on the Microstructure of procedures allows for the development of significantlyI NTELLECTUALdifferent policy alternatives. We first develop a model for the demand side of health care and demonstrate that demand can be controlled by pricing, namely exogenous factors, as well as by endogenous factors relating to the management of the Health Care process in the United States. We then address several issues on the supply side, starting first at the qualityTerrence issue and then P. in termsMcGarty of short and long term productivity issues. Health Care is a highly distributed process that is an ideal candidate for the distributed information infrastructures that will be available in theCopyright twenty ©first 201 century.2 The Telmarc It is Group, all rights reserved The Telmarc Group, LLC, January 15, 2009, Copyright ©2009 all rights reserved www.telmarc.com . This document is solely the opinion of the author and Telmarc and in no way reflects a legal or financial opinion or otherwise. The material contained herein, as opinion, should not be relied upon for any financial investment, legal actions or judgments, and the opinion contained herein is merely reflective of facts observed by the Page 1 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Page 2 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Page 3 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY BOOKS BY THE AUTHOR NON FICTION STOCHASTIC SYSTEMS AND STATE ESTIMATION (1974) SATELLITE COMMUNICATIONS SYSTEMS (1982) BUSINESS PLANS (1988) MULTIMEDIA COMMUNICATIONS SYSTEMS (1989) TELECOMMUNICATIONS LAW AND POLICY (1999) DD 649: THE ALBERT W GRANT: COMMON MEN AND THEIR UNCOMMON ACTS (2007) HEMEROCALLIS: SPECIES, HYBRIDS AND GENETICS (2008) HEALTH CARE POLICY: POLITICS V REALITY (2009) OBESITY AND TYPE 2 DIABETES: CAUSE AND EFFECT (2010) PROGRESSIVISM, INDIVIDUALISM AND THE PUBLIC INTELLECTUAL (2011) CANCER GENOMICS: A SYSTEMS APPROACH (2011) FICTION SEEDS OF DESTRUCTION (2005) THE JOURNAL OF GABRIELLUS: THE WORLD OF THE SEVENTH CENTURY (2006) THE SQUIRREL TALES (2010) Page 4 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY PROGRESSIVISM, INDIVIDUALISM, AND THE PUBLIC INTELLECTUAL BY TERRENCE P MCGARTY Page 5 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Copyright ©2012 The Telmarc Group, LLC, all rights reserved www.telmarc.com . This is a working draft and may be changed from time to time. It is not anticipated to be fully completed until late 2012 or early 2013. Thus there may be changes in opinion as new information is obtained and/or reexamined. Comments are welcome, send to: [email protected] Page 6 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Page 7 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Preface There is a great deal of confusion over the ideas of liberals and conservatives. Then we add libertarians, which often sound interesting but when carried to their ultimate ends oftimes results in less than reasonable solutions. This work was prepared to address a simple question: what are the two extremes in our current society, how are they characterized and what intellectual basis does each have. We all know that we have a debt of gratitude to men such as John Locke and Thomas Paine. In a small park in Morristown just a short distance from where I live and write, there is a statue of Paine, hidden in a small niche of a duck pond surrounded by Canada Geese. I doubt if anyone ever visits there, except perhaps me, from time to time, but it is the largest such statue in the US. Paine wrote Common Sense and Washington read Paine's famous script to his soldiers before crossing the Delaware. But Paine also was the first to suggest income taxes, health care, retirement plans. Paine saw the Government having this role, but this was conceived when he was assisting the French, well after he left the new United States. Thus, in many ways, Paine was the first Progressive, looking at society and at the Government providing support to all. In contrast Locke was the influence on the founders, looking at the individual and the sanctity of property. Individualism versus Progressive theories, two extremes which influence the underpinnings of our current society. To understand these better is why I have attempted this book. The approach I have taken is to focus on the thoughts and words of several of the key players on both sides. This is not a complete list in any manner or form. It reflects clearly a personal bias based upon some forty years of considering these issues from a variety of perspectives. For example, I first had to deal with Rawls more than a dozen years ago in the context of a discussion on telephone universal service. To understand certain regulators and to understand the positions of certain advocacy groups one need to understand Rawls. To some that would sound extreme but it is akin to psychiatry, one needs to understand more than just what meds to use to calm the patient down, the history is important also as is the patients world view. A second issue to try and place one's self in the mind of the other side. For example, Progressives have such a strong belief in the Government. Having spent my tour in Washington and in and around the Carter Administration, I often wonder why anyone would trust Washington to do anything, even control traffic lights in the District! But that is my view and that would not solve any problem of understanding the Progressive. I also have another problem relying upon Government, it changes. The people "solving" your problem today may not be there in a month, a year, whatever. Thus how could one therefore rely on Government given its changeability. Again one must try to understand the side which believes that. From whence did that belief arise. What basis do they have for believing that their position has sustainable applicability? Page 8 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY A deeper understanding of the personality of each of the individuals we present herein may be worth a study. What were they like as individuals, what characteristics did they have which made them act and think the way they did. For example, what makes a true socialist? Not that we speak of socialists but to be one requires a certain mind set and world view. What makes a full Libertarian? By this I mean the extreme Ayn Rand type libertarian, not one which I speak of herein, one where we establish and protect individual rights, but one which takes the rights and then individually disregards all others to benefit themselves alone. Thus there are many dimensions in allocating positions to all of these political nametags. It is not a simple linear left to right, liberal to conservative layout. It is much more complex. Thus one of the objectives herein is also to explore that multidimensionality. The strange thing that I have noticed is the current Progressives speak of having the Government intervene on behalf of society, the people, with corporations to ensure that the corporations are doing no harm. There is still the belief that large corporations have evil intents and that the people need protection. In my experience there is little evil intent, other than perhaps with certain players on Wall Street who could financially benefit from evil, yes there can be hedges on good versus evil. Most non-financial entities are at best as bureaucratic as Government. There are Enron and World Com, but for the most they are benign, they need customers, and there is little market control of the Trust days. This is a book which supports the principles of individualism, in the context of Mill more than of Spencer. It is a book with a belief in the principles of the founders and a dislike for the arrogance of those who presuppose that they know better. It supports the entrepreneur rather than the bureaucrat. Thus what follows has a strong bias and a point of view. Thus this work explores these many issues. Not all the answers are readily available. Insight is there which adds to what is already known, and the list of significant players is much longer than what I have provided. Hopefully this is a start. Terrence P McGarty Florham Park, NJ December 2010 Page 9 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY Page 10 DRAFT NOT FOR ATTRIBUTION, REVIEW ONLY 1 Introduction ______________________________________________________ 15 1.1 Individualism _______________________________________________________ 16 1.1.1 Huntington and The Clash __________________________________________________ 16 1.1.2 Manent and Liberalism ____________________________________________________ 18 1.1.3 Tocqueville and His Perceptions _____________________________________________ 22 1.1.4 Lukes and Individualism ___________________________________________________ 23 1.1.5 The Existentialists ________________________________________________________ 26 1.1.6 Primary Alternative Thinkers _______________________________________________ 27 1.1.7 The Evolving Concept of Individualism _______________________________________ 29 1.1.8 Individualism Defined _____________________________________________________ 30 1.2 Progressivism _______________________________________________________ 32 1.2.1 The Legacy of Hegel ______________________________________________________
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